Related Topics: Features, Hormones, Natural Progesterone, Treatments

A Woman’s Hormones – What She Needs

Women are ruled by their two main hormones: progesterone and oestrogen, but with the rise of synthetic hormones in the Pill, Coil and HRT do you know the difference why you need bio-identical hormones and not their chemical equivalents?

Dame Dr Shirley Bond

There has been some confusion about what constitutes natural, or bio-identical, hormones so let’s start by looking at the role of those hormones.

What are hormones?

The Ovaries act as endocrine glands when they produce the oestrogens and progesterone that control a woman’s menstrual cycle and fertility.  They make some very important hormones and amongst these are three oestrogens, as well as progesterone.  These hormones then pass into the blood stream where they are transported to wherever they are needed in the body.

The Oestrogens

The ovaries produce the three oestrogens: Oestradiol, Oestrone and Oestriol.  These are secreted in different amounts and ratios to each other at different stages in a woman’s life.

Oestradiol is the strongest and is produced in large amounts by the ovaries during a woman’s reproductive years.

Oestriol is a gentle oestrogen produced in large quantities by the placenta during pregnancy and also in larger quantities after the menopause.

Oestrone is also produced in greater amounts after the menopause and it too is also a gentler oestrogen than oestradiol.

Sometimes the total amount of oestrogens produced after the menopause can be as high as before the menopause. This can then produce a situation of oestrogen dominance because ovulation has ceased and the amount of progesterone being produced has dropped considerably. This may need to be corrected with progesterone supplementation.


Progesterone is produced throughout the monthly cycle, but the amount increases at ovulation as one of its important roles is to prepare the body for pregnancy. Progesterone is also very important in that it protects the body against the unwanted effects of the oestrogens. These include:

increase in stimulation of the lining of the uterus

stimulation of breast tissue

weight increase

fluid retention

mood swings

Hormone Treatment

There are times when the body’s hormones are out of balance and additional amounts may be given.  There are two types that are available:

1. Natural, or bio-identical, hormones which are molecularly identical to those made by the body.

2. Synthetic, or chemical, hormones and, although these have similar actions to our own body’s natural hormones, they also have additional and often unwanted and potential dangerous actions.  This is because their molecular structure is different from the body’s natural hormones;  that is to say that they are not identical to those made by the body.

Standard HRT

This is usually prescribed to contain oestradiol combined with a chemical progestogen (not progesterone as made by the ovary) in a standard dose.

The progestogen is put into the mixture for one reason only: to protect the uterus from over stimulation by the oestradiol. This over stimulation if not controlled can lead to cancer of the uterus.  The reason a chemical progestogen is used rather than the bio-identical progesterone is because natural progesterone cannot be patented, but the chemical form can.

Sadly, the artificial progestogen does not protect the body from any of the other unwanted effects of oestrogens either.  In addition it is now realised that these progestogens can in fact increase the risk of over stimulation of the breasts by oestrogen.

In recent surveys it has been found that women who take oestradiol combined with progestogens (normal HRT) have a slightly higher risk of breast cancer than women who only take oestradiol.

Oestradiol on its own is usually only prescribed to women who have had a hysterectomy.

Bio-Identical HRT

When bio-identical HRT is prescribed it is usual for a combination of the three naturally occurring oestrogens combined with progesterone to be used. This means that the body is receiving as near as possible the combination of hormones that the ovaries themselves produced. Also the progesterone protects the body against all the unwanted effects of oestrogens, not just the uterus. This means that the increased risk of breast cancer that exists when taking additional oestrogens should be considerably less than when taking traditional HRT.

The dosage of these oestrogens and progesterone is individually adjusted to the individual woman and based upon her response to them, not given as a standard dose.

The dosage can be adjusted by reference to a blood or saliva test but this is not as reliable a way as simply adjusting the dosage to the woman’s response to the hormones.

The reason for this is that the results of both blood tests and saliva testing of hormones will vary from day to day and the actual hormone blood level required by one woman will not be the same as another.

Sometimes instead of prescribing all three oestrogens the doctor may just prescribe the weak oestriol, or oestriol and oestrone combined with progesterone.

How Is It Given?

The three bio-identical oestrogens are given as a tablet (Hormonin) and Oestradiol can be prescribed as a vaginal cream or pessary or as a tablet (Ovestin).

The Progesterone can be prescribed as a transdermal cream (such as Wellsprings Serenity), a tablet (Uterogestan) or as suppositories (Cyclogest).

Further reading:

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New comments are now closed on this article
Comments 6
Sorted by:  Date | Recommended
AnnA Rushton | 9:52 am, May 14th, 2021

It is not too late, but in order to give you more detailed advice please email for individual help with your symptoms as they will be able to go into more detail than is possible here.

Susan Reid | 8:40 am, May 14th, 2021

Good morning,
I am 4 years post menapause, I decided not to go on HRT due to the risks.
Is it too late for me to take bio-hormone replacement? What would recommend?
Best wishes

AnnA Rushton | 9:40 am, June 18th, 2013

Serenity is progesterone only Anne and will help with your symptoms.

Anne | 10:52 pm, June 7th, 2013

Hi I was on HRT A LONG TIMEand ended up with Breast Cancer,Oestergen Receptive.IMon Fermara now for 5 years and still get bad flushes and miss Hrt as I had no symptoms when on it.Can u recommend anything not Oestergen based that I could use to relieve symptoms,Thanking u so much.

Dr Tony Coope | 8:44 pm, May 28th, 2013

Kelsey: if you e-mail me your address, date of birth, and landline telephone details, I can order a saliva test kit (or kits, – depending on what you need) to be sent to you. But it would be best to have a talk first to see just what would be appropriate for you. Any treatment would naturally take into account the test results.

kelsey checklin | 7:35 pm, May 28th, 2013

hello how do i get in contact about getting tested? and hopefully having treatment?

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